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NPI Code Detail

MEDICARE: GEORGE S MALOUF JR. M.D.

MEDICARE: GEORGE S MALOUF JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology PhysicianD0024043MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10465204OTHERMDAETNA
222940001OTHERMDBC/BS
325223OTHERMHMDIPA/OPTIMUM CHOICE

General Provider Information

NPI Number : 1053381210
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE S MALOUF JR. M.D.
Provider Business Mailing Address
First Line : 4400 TELFAIR BLVD STE D
Second Line :
City : CAMP SPRINGS
State : MD
Zip : 20746-5217
Country : US
Telephone Number : 301-423-5252
Fax Number :
Provider Business Practice Location Address
First Line : 4400 TELFAIR BLVD STE D
Second Line :
City : CAMP SPRINGS
State : MD
Zip : 20746-5217
Country : US
Telephone Number : 301-423-5252
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 07/21/2022

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